Organization
COUNTIES OF JEROME LINCOLN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN BRIDWELL (BUSINESS MANAGER)
(208) 324-2392
Entity
Organization
Contact information
Practice address
830 10TH AVE EAST, JEROME, ID 83338
(208) 324-3361
(208) 324-3362
Mailing address
125 4TH AVE WEST, JEROME, ID 83338
(208) 324-2392
(208) 324-7609
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805094400
—
ID
Enumeration date
01/22/2007
Last updated
09/25/2025
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